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Abstract

In the context of new coronavirus COVID-2019 infection spread, many students in numerous higher education institutions have undergone the transition to education applying distance learning technology while medical students undergo partially remote education. It is worth noting that in the setting of the COVID-19 pandemic, remote education is the best prevention measure for decrease in incidence of the new coronavirus infection among students.

Abstract

The article presents results of a concise analysis of domestic and foreign literature addressing the problem of determining of distinctive diagnostic features in patients with Clouston syndrome as an orphan disease rarely encountered in clinical practice of dentistry. A clinical case of effective orthopaedic rehabilitation of a 10-years-old patient with Clouston syndrome and congenital edentulism using minimally invasive orthopaedic dentistry measures: removable dentures application using shape memory materials is presented. Technological peculiarities and advantages of the chosen approach to treatment are described. Photographic documents of orthopaedic dental treatment results including long-term results within the follow-up period of 10 years are presented providing strong evidence of effective aesthetic, functional and social rehabilitation of the patient. Detailed analytical conclusion is drawn according to the study results.

Abstract

Hypomimia is a common symptom of Parkinson’s disease. At the present time, issues related to existence of interrelations between hypomimia and manifestations of common hypokinesia remain under-investigated in aspects of both clinical manifestations and rehabilitation efficacy. An objective method for facial muscle movement diagnostics is necessary to achieve this goal. The article presents novel experience in application of a proprietary method using objective facial expression assessment video analysis on the example of a healthy female subject and a female patient with Parkinson’s disease. The Parkinson’s female patient had objective symptoms of hypomimia: a decrease in velocity and amplitude of eyebrow and mouth movement, slow winking. Therefore, application of this method creates prerequisites for more in-depth study of theoretical and clinical aspects in facial expression of Parkinson’s disease patients.

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a major multidrug-resistant nosocomial pathogen. This class of MRSA, first reported in the early 1960s and now termed healthcare-associated MRSA (HA-MRSA), was followed by a newer class of MRSA, community-associated MRSA (CA-MRSA). The unique feature of the initial CAMRSA included Panton-Valentine leukocidin (PVL), an abscess-associated toxin and also S. aureus spread factor. CA-MRSA usually causes skin and soft-tissue infections, but occasionally causes invasive infections, including (necrotizing) pneumonia, sometimes preceded by respiratory virus infections. The most successful CA-MRSA USA300 (ST8/SCCmecIVa) caused an epidemic in the United States. In Russia, we first detected PVL-positive CAMRSA (ST30/SCCmecIVc) in Vladivostok in 2006, but with no more PVL-positive MRSA isolation. However, we recently isolated four lineages of PVL-positive MRSA in Krasnoyarsk. Regarding chemotherapy against invasive MRSA infections, vancomycin still remains a gold standard, in addition to some other anti-MRSA agents such as teicoplanin, linezolid, and daptomycin. For resistance, vancomycin-resistant MRSA (VRSA) with MICs of ≥16 μg/mL appeared in patients, but cases are still limited. However, clinically, infections from strains with MICs of ≥1.5 μg/mL, even albeit with susceptible MICs (≤2 μg/mL), respond poorly to vancomycin. Some of those bacteria have been bacteriologically characterized as vancomycin-intermediate S. aureus (VISA) and heterogeneous VISA (hVISA), generally with HA-MRSA genetic backgrounds. The features of the above PVL-positive Krasnoyarsk MRSA include reduced susceptibility to vancomycin, which meets the criteria of hVISA. In this review, we discuss a possible new trend of PVL-positive hVISA, which may spread and threaten human health in community settings.

Abstract

Oxidative stress is one of the most important mechanisms of cardiovascular diseases, especially in heart failure. Mitochondrial dysfunction and inflammation play a major role in formation of free radicals and antioxidants. The association between oxidative stress, telomere biology and cell senescence plays the key role in cardiovascular pathology development. The paper considers role of pro-oxidant and antioxidant enzymes in heart pathology development. Specifically, the role of such antioxidant enzymes as glutathione peroxidase 3, catalase, and superoxide dismutase is described. The role of gamma-glutamyl transferase is emphasized as its activity increases significantly in cases of heart failure, coronary heart disease, stroke, arterial hypertensions, and arrhythmias. This article is a literature review of the effect of such antioxidants as alpha-tocopherol, ubiquinone, uric acid, and triiodothyronine on development of heart failure and myocardial infarction. A decrease in triiodothyronine concentration is a risk factor for coronary heart disease. High uric acid values in patients with myocardial infarction upon admission to the hospital are associated with a high risk of sudden death. The influence of such minerals such as zinc, copper, magnesium, selenium, potassium, sodium, calcium, and iron on heart failure development has been analyzed. The role of ceruloplasmin as an independent predictor of acute and chronic cardiac disorders cardiac events, mortality, and bad prognosis in patients with heart failure and myocardial infarction is examined. The authors demonstrate the influence of inflammation on heart failure development as well as association of inflammation with oxidative stress.

Abstract

Introduction: Currently, the Doctor-Patient relationship of all cultures and societies is in crisis due to the distrust that has arisen in this social contract. This distrust origins from various changes that have occurred worldwide. We, as doctors, can contribute to solving this crisis, reaffirming the values that integrate medical professionalism. In the absence of specific studies and programmes on medical professionalism in Spanish universities, we consider knowing the perception of medical professionalism by medical students at the University of Murcia essential to see if there is a need to introduce educational improvements in our faculty.

Methods: A professionalism questionnaire from the Penn State University School of Medicine (PSCOM) was provided online, voluntarily and anonymously to all students of the Medicine degree of the University of Murcia.

Results: The perception of professionalism in students was high, since all categories have more than 75% positive responses on average. The categories of Respect and Altruism were the best rated. On the other hand, there is a slight increase in negative responses as students progress through the degree. Between sexes, however, there were no differences in the criteria.

Conclusions: Although the perception of professionalism is good, it is still a perception, so it should reach values closer to 100%. Therefore, the faculty is encouraged to carry out specific programmes to promote medical professionalism in the degree courses.

Abstract

I reported a case of a seventy-five-year-old woman with a backache and pain in left femur. Magnetic resonance imaging (MRI) of back, pelvis and hips showed bone marrow lesion suggesting bone metastasis. The patient was admitted to nuclear medicine department of Krasnoyarsk Regional Clinical Oncology Center. Single-photon emission computed tomography combined with computed tomography (SPECT/CT) of the skeletal system together with several laboratory tests (alkaline phosphatase, calcium, phosphorus), provided grounds for the diagnosis of Paget’s disease. The patient was qualified for treatment to the Rheumatologist.

Abstract

Background: pulmonary edema results from the shift of excessive fluid into the alveoli space and can be clinically classified into cardiogenic or non-cardiogenic by pathophysiology. This study aimed to elucidate the mechanism, outcomes, and prevention of poisoning induced non-cardiogenic pulmonary edema (PINCPE).

Materials and methods: we conducted a study on etiology, epidemiology, mechanism, risk, and length of hospital stay in PINCPE. A PubMed search using terms: poisoning and non-cardiogenic pulmonary edema. From 1986 to 2017, a total of 15 articles with 16 cases (2 cases in one article) were included. Cut-off value of mean age was used for classification of subjects into younger group and older group, and length of stay (LOS) was compared between the two groups.

Results: the age range of the patients was 7 to 72 years, and the average age (mean ± SD [standard deviation]) was 35.7±19.5 years. Among the reported substances in PINCPE, calcium channel blockers (CCBs) were most frequently used (n=8; 50%). In electrocardiogram (ECG), sinus tachycardia (n=8; 50%) was the most common finding. The overall rate of intubation with mechanical ventilator support was 81.3%. The mortality rate was 12.5%. Among patients with PINCPE, LOS was significantly shorter in the younger group aged <35.7 years than in the older group (5.7 vs. 8.9; p=.022).

Conclusion: CCB was the most common etiologic agent in PINCPE. Up to 81.3% of PINCPE cases required intubation with ventilator support due to respiratory failure. LOS may increase 3.2 days if the case is complicated with extra-pulmonary organ failure.